Epidemiology and in-hospital outcome of stroke in South Ethiopia

Deresse, Birrie; Shaweno, Debebe

doi:10.1016/j.jns.2015.06.001

Cited by 94 publications

(153 citation statements)

References 31 publications

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“…However, hospital-based data on stroke are available from low-income countries, such as Ethiopia, the Gambia, Malawi, Mozambique, and Uganda [9–13]. These five studies were mostly carried out in referral hospitals, but none had a stroke unit [14].…”

Section: Introductionmentioning

confidence: 99%

“…These five studies were mostly carried out in referral hospitals, but none had a stroke unit [14]. The age (median or mean) of these patients was in the sixth or seventh decennium [9–13]. The majority of the patients had severe stroke symptoms measured by the National Institutes of Health Stroke Scale (NIHSS) or the Scandinavian Stroke Scale [9–11, 13].…”

Section: Introductionmentioning

confidence: 99%

“…The age (median or mean) of these patients was in the sixth or seventh decennium [9–13]. The majority of the patients had severe stroke symptoms measured by the National Institutes of Health Stroke Scale (NIHSS) or the Scandinavian Stroke Scale [9–11, 13]. Hypertension as a risk factor ranged from 48% in the Gambia to 86.2% in Mozambique [10, 12].…”

Section: Introductionmentioning

confidence: 99%

“…Hypertension as a risk factor ranged from 48% in the Gambia to 86.2% in Mozambique [10, 12]. Between 25.8 and 43.6% had hemorrhagic stroke in the studies, in which the pathological stroke type was confirmed by brain imaging or autopsy [9, 11–13]. In-hospital stroke mortality ranged from 14.7% in Ethiopia to 41% in the Gambia [9, 10].…”

Section: Introductionmentioning

confidence: 99%

“…Between 25.8 and 43.6% had hemorrhagic stroke in the studies, in which the pathological stroke type was confirmed by brain imaging or autopsy [9, 11–13]. In-hospital stroke mortality ranged from 14.7% in Ethiopia to 41% in the Gambia [9, 10]. The in-hospital stroke mortality rates from these countries were considerably higher than that reported from high-income countries [15].…”

Section: Introductionmentioning

confidence: 99%

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Stroke in a resource-constrained hospital in Madagascar

et al. 2017

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BackgroundStroke is reported as the most frequent cause of in-hospital death in Madagascar. However, no descriptive data on hospitalized stroke patients in the country have been published. In the present study, we sought to investigate the feasibility of collecting data on stroke patients in a resource-constrained hospital in Madagascar. We also aimed to characterize patients hospitalized with stroke.MethodsWe registered socio-demographics, clinical characteristics, and early outcomes of patients admitted for stroke between 23 September 2014 and 3 December 2014. We used several validated scales for the evaluation. Stroke severity was measured by the National Institutes of Health Stroke Scale (NIHSS), disability by the modified Rankin Scale (mRS), and function by the Barthel Index (BI).ResultsWe studied 30 patients. Sixteen were males. The median age was 62.5 years (IQR 58–67). The NIHSS and mRS were completed for all of the patients, and BI was used for the survivors. Three patients received a computed tomography (CT) brain scan. The access to laboratory investigations was limited. Electrocardiographs (ECGs) were not performed. The median NIHSS score was 16.5 (IQR 10–35). The in-hospital stroke mortality was 30%. At discharge, the median mRS score was 5 (IQR 4–6), and the median BI score was 45 (IQR 0–72.5).ConclusionsAlthough the access to brain imaging and supporting investigations was deficient, this small-scale study suggests that it is feasible to collect essential data on stroke patients in a resource-constrained hospital in Madagascar. Such data should be useful for improving stroke services and planning further research. The hospitalized stroke patients had severe symptoms. The in-hospital stroke mortality was high. At discharge, the disability category was high, and functional status low.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Stroke in a resource-constrained hospital in Madagascar

et al. 2017

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Predictors of 30‐day mortality following the first episode of stroke among patients admitted at referral hospitals in Dodoma, central Tanzania: A prospective longitudinal observational study

Chongolo,

Alphonce,

Mbelele

et al. 2024

Health Science Reports

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Background and AimsStroke is the leading cause of disability and the second most common cause of death after ischemic heart disease worldwide. Understanding predictors of early poststroke mortality provides opportunities for interventions and favorable outcomes. This study aimed to determine the incidence and predictors of 30‐day mortality among patients admitted with the first stroke at referral hospitals in Dodoma.MethodsA prospective longitudinal observational design enrolled patients with acute stroke confirmed by CT scan or MRI admitted at referral hospitals in Dodoma. The National Institute of Health Stroke Scale was used to assess stroke severity at baseline. A comparison of risk factors, clinical profiles, and mortality was done using the Chi‐square test. A logistic regression model was used to determine the predictors of 30‐day mortality in patients with the stroke while the 30‐day probability of survival was estimated using Kaplan−Meier analysis.ResultsOut of 226 patients with first‐ever stroke, 121(54%) were males, and the population mean age was 63(15) years. The 140(62%) had Ischemic stroke, and 154(68%) survived at the 30th day. Patients with a history of smoking 2.4 [95% confidence interval (CI) (1.0−5.6), p = 0.048], loss of consciousness 2.7 [95% CI (1.2−6.4; p = 0.019] and unequal pupil size 13.7 [95% CI (4.1−58.1, p < 0.001 were significantly more associated with mortality within 30 days. The median survival was 7 (3−9) days, whereas alcohol drinkers and those aged above 60 years had a shorter time to mortality compared to non‐alcohol drinkers and those aged <60 years.ConclusionThe study showed a high incidence of mortality within 30 days after the first stroke episode, with the highest proportion dying within 7 days of being hospitalized. Advanced age of ≥60 years, smoking, alcohol use, and severe stroke at admission warrant special attention.

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Prospective assessment of patients with stroke in Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia

Zewdie

Debebe

Kebede

et al. 2018

African Journal of Emergency Medicine

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IntroductionThe burden of stroke is increasing in many low- and middle-income countries. In Ethiopia, stroke has become a major cause of morbidity, long-term disability, and mortality. Time from stroke onset to hospital presentation is a critical factor in acute stroke care. This study aimed to describe risk factors for stroke and clinical presentation of patients presenting to the emergency centre with stroke.MethodsWe conducted a cross sectional study conducted from August 2015 to January 2016 in an urban tertiary care centre in Addis Ababa, Ethiopia. Descriptive statistics and multivariable logistic regression models were used to evaluate associations between stroke types and stroke risk factors, and delayed presentation and clinical indicators. P-values less than .05 were considered statistically significant.ResultsA total of 104 patients were included. The mean age was 53 years, and 56% were male. Only 30% of patients arrived using an ambulance service. The most common presenting symptoms were altered mental status (48%), hemiparesis (47%), facial palsy (45%), hemiplegia (29%), and aphasia (25%). Hypertension was the most common risk factor (49%), followed by cardiovascular disease (20.2%) and diabetes mellitus (11%). The majority of strokes were haemorrhagic in aetiology (56%). The median arrival time to the emergency centre was 24 h after symptoms onset; only 15% presented within three hours. Patients with hypertension, or presented with loss of consciousness were significantly more likely to have haemorrhagic stroke (p < .001 and p = .01 respectively). The only risk factor robustly associated with ischaemic stroke was cardiac illness (odds ratio 3.99, p = .01).DiscussionOur study identified hypertension to be the most common risk factor for stroke. The predominant aetiology type in this cohort is haemorrhagic stroke. Lastly, the median arrival time to an emergency centre was 24 h after symptom onset.

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Epidemiology and in-hospital outcome of stroke in South Ethiopia

Cited by 94 publications

References 31 publications

Stroke in a resource-constrained hospital in Madagascar

Stroke in a resource-constrained hospital in Madagascar

Predictors of 30‐day mortality following the first episode of stroke among patients admitted at referral hospitals in Dodoma, central Tanzania: A prospective longitudinal observational study

Prospective assessment of patients with stroke in Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia

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